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Support Care Cancer. 2017 Jul;25(7):2063-2073. doi: 10.1007/s00520-017-3595-x. Epub 2017 Feb 14.

Follow-up after curative treatment for colorectal cancer: longitudinal evaluation of patient initiated follow-up in the first 12 months.

Author information

1
Health Sciences, Nightingale Building, University of Southampton, Highfield, Southampton, Hampshire, SO17 1BJ, UK. Lbatehup@soton.ac.uk.
2
Health Sciences, Nightingale Building, University of Southampton, Highfield, Southampton, Hampshire, SO17 1BJ, UK.
3
School of Economics, University of Surrey, Guildford, Surrey, GU2 7XH, UK.
4
Department of Mathematics, University of Surrey, Guildford, Surrey, GU2 7XH, UK.
5
Cancer Research UK, Clinical Research Unit, University of Southampton, Tremona Road, Southampton, Hampshire, SO16 6YD, UK.
6
Health Psychology Consultancy Ltd., Staffordshire, UK.
7
University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, Hampshire, SO16 6YD, UK.
8
Centre for Technology Enabled Health Research, Faculty of Health and Life Sciences, Coventry University, Priory Street, Coventry, CV1 5FB, UK.
9
The University of Nottingham, Executive Office, Trent Building, University Park, Nottingham, NG7 2RD, UK.

Abstract

PURPOSE:

To compare patient-triggered follow-up (PTFU) for curatively treated colorectal cancer against traditional outpatient follow-up (OPFU).

METHODS:

Questionnaires were mailed at four time points over one-year post-treatment to two prospectively-recruited cohorts: A, patients entering follow-up and receiving OPFU pre-implementation of PTFU; B, patients entering follow-up (FU) and receiving either OPFU (B1) or PTFU (B2) post-implementation of PTFU. Bi-variate tests were used to compare patient characteristics and outcomes eight months after entering follow-up (generic and cancer-specific quality of life (QoL), satisfaction). Regression analysis explored associations between follow-up model and outcomes. Resource implications and costs of models were compared.

RESULTS:

Patients in Cohort B1 were significantly more likely to have received chemotherapy (p < 0.001), radiotherapy (p < 0.05), and reported poorer QoL (p = 0.001). Having a longstanding co-morbid condition was the most important determinant of QoL (p < 0.001); model of care was not significant. Patients were satisfied with their follow-up care regardless of model. Health service costs were higher in PTFU over the first year CONCLUSIONS: PTFU is acceptable to patients with colorectal cancer and can be considered to be a realistic alternative to OPFU for clinically suitable patients. The initial costs are higher due to provision of a self-management (SM) programme and remote surveillance. Further research is needed to establish long-term outcomes and costs.

KEYWORDS:

Aftercare; Colorectal cancer; Follow-up; Patient triggered-follow-up; Remote surveillance

PMID:
28197848
PMCID:
PMC5445145
DOI:
10.1007/s00520-017-3595-x
[Indexed for MEDLINE]
Free PMC Article

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